Fusobacterium necrophorum is a gram-negative anaerobic bacillus that can cause serious systemic infections typically in previously healthy young adults. Lemierre's syndrome, also known as post-anginal sepsis or necrobacillosis, is the infection most usually associated with F. necrophorum. However, F. necrophorum is also a very rare cause of anaerobic endocarditis. Mortality and rates of thromboembolism are high with F. necrophorum endocarditis. In this article, we describe a case of F. necrophorum native valve infective endocarditis. The patient was treated with penicillin plus clindamycin followed by penicillin alone for 6 weeks resulting in complete resolution of infection. © 2011 Elsevier Inc.